Logical Model for HIV.D Care-Treatment data elements.

Whether visit was scheduled or unscheduled, clinical only, or for ARV drug pick-up

The clients first appointment for clinical care by a provider at the facility

Appointment for clinical care by a provider

Appointment for initiation of ART

Appointment for an antiretroviral drug pick up

Visit to address issues and concerns

Appointment for a post-treatment follow-up visit for cervical precancer lesions or invasive cervical cancer

Is this is a scheduled visit?

Temperature of the client in Celsius

The number of breaths per minute

The number of heartbeats per minute

The clients height in centimetres

The clients current weight in kilograms

Systolic blood pressure (SBP) in mmHg

Diastolic blood pressure (DBP) in mmHg

If the clients blood pressure cannot be taken, this should be indicated here. Otherwise, blood pressure should be measured.

Signs that may indicate the client has a serious illness and needs triage or an emergency referral

Client has a fever with a measured temperature of 102.2 F/39 C or greater

Heart rate above a rate per minute based on age

Respiratory rate above a number of breaths per minute based on age

Client is not able to walk without help

Client is exhibiting lethargy as a sign of serious illness

Client is currently unconscious

Client is convulsing

Child is not able to drink

Infant or child is not able to breastfeed

Client is repeatedly vomiting

Client is exhibiting a headache

Client is exhibiting another sign of a serious illness

Client is exhibiting another sign of a serious illness (specify)

Client is currently pregnant

Client is giving infant breast milk

Total number of times the woman has been pregnant (gravida)

Total number of pregnancies lost/ended due to miscarriages and/or abortions before 22 weeks/5 months

Total number of live births after 22 weeks

Calculated parity is the total number of live and stillbirths

Clients HIV status is different from a current partners HIV status

Client is currently taking ART

The date on which the client started or restarted ART

Client stopped taking ART

Date on which client stopped ART

Is the client successfully established on ART?

Whether the client is ART naive or is restarting ART

Client is ART naive, having never taken ART to treat HIV before

Client is restarting ART after stopping treatment for any reason

The date on which the client was first initiated on ART

Time the client has been on ART since starting or restarting it in years and months

Date(s) client restarted ART after stopping (intentionally interrupting) for any number of reasons (see "Reason ART stopped")

Month and year client originally started ART (documented) at a health facility in the system. The cohort is a group of patients who started ART in the same month (or quarter) and year, whose status is followed over time, using the ART register.

Client is transferring in with records or known ART drugs and ART start date

Date client presented at facility (with transfer/referral slip) from another facility (and on ART) within the system

Name of health facility client was transferred from

Date client first enrols in HIV care at the facility. Begins when a person with a confirmed HIV diagnosis presents to a facility where HIV care is provided and a medical record, patient card, file or chart is opened for the first time. This could be at an HIV care/ART, MNCH or TB clinic.

Clients age when the client was enrolled in ART care

Facility where the client first enrolled in HIV care

Whether or not the client received ARV drugs prior to enrolling into HIV care

Client received no prior ARVs

Client received ARVs prior without records/documentation

Client received ARVs during pregnancy or breastfeeding

Client received ARVs for post-exposure prophylaxis (PEP) or PrEP

Client received ARV prophylaxis for an HIV-exposed infant

Date ARV drugs were started prior to enrolment into HIV care/ART

Health facility (or other location) where ARV drugs were received prior to enrolment into HIV care/ART

ARV drug regimen received prior to enrolment into HIV care/ART

Does the client have any current chronic health conditions or problems?

Client does not have chronic diseases or any past health conditions

Client does not know whether she has any chronic diseases or past health conditions

Client has diabetes of other or unspecified type

Client has pre-existing type 1 diabetes mellitus

Client has pre-existing type 2 diabetes mellitus

High blood pressure

Other health conditions not included in the list

Other health conditions not included in the list (specify)

Original full, first-line ARV drug regimen patient started on at this facility

The current ART regimen the client is taking

The date on which the client started taking the current ART regimen

The preferred first-line ART regimen for the client according to WHO (or national) guidelines

The alternative first-line ART regimen for the client according to WHO (or national) guidelines

The first-line ART regimen for the client under special circumstances according to WHO (or national) guidelines

The preferred second-line ART regimen for the client according to WHO (or national) guidelines

The alternative second-line ART regimen for the client according to WHO (or national) guidelines

The optimal regimen for transition to DTG-based regimens for children established on ART

ART regimen for treating clients living with HIV, based on national guidance

First-line ART regimen for adults and adolescents living with HIV

First-line ART regimen for children living with HIV

First-line ART regimen for neonates living with HIV

Second-line ART regimen for adults and adolescents living with HIV

Second-line ART regimen for children living with HIV

Third-line ART regimen for people living with HIV (Not defined by WHO. National programmes should develop policies for third-line ART)

List of ART regimens

Regimen containing abacavir, lamivudine, and atazanavir/ritonavir

Regimen containing abacavir, lamivudine, and dolutegravir

Regimen containing abacavir, lamivudine, and efavarinez

Regimen containing abacavir, lamivudine, and lopinavir/ritonavir

Regimen containing abacavir, lamivudine, and nevirapine

Regimen containing abacavir, lamivudine, and raltegravir

Regimen containing zidovudine, lamivudine, and atazanavir/ritonavir

Regimen containing zidovudine, lamivudine, and darunavir/ritonavir

Regimen containing zidovudine, lamivudine, and dolutegravir

Regimen containing zidovudine, lamivudine, and efavirenz

Regimen containing zidovudine, lamivudine, and efavirenz 600 mg

Regimen containing zidovudine, lamivudine, and lopinavir/ritonavir

Regimen containing zidovudine, lamivudine, and nevirapine

Regimen containing zidovudine, lamivudine, and raltegravir

Regimen containing tenofovir alafenamide, lamivudine, and dolutegravir

Regimen containing tenofovir alafenamide, emtricitabine, and dolutegravir

Regimen containing tenofovir disoproxil fumarate, lamivudine, and atazanavir/ritonavir

Regimen containing tenofovir disoproxil fumarate, lamivudine, and darunavir/ritonavir

Regimen containing tenofovir disoproxil fumarate, lamivudine, and dolutegravir

Regimen containing tenofovir disoproxil fumarate, lamivudine, and efavirenz

Regimen containing tenofovir disoproxil fumarate, lamivudine, and efavirenz (400 mg)

Regimen containing tenofovir disoproxil fumarate, lamivudine, and efavirenz (600 mg)

Regimen containing tenofovir disoproxil fumarate, lamivudine, and lopinavir/ritonavir

Regimen containing tenofovir disoproxil fumarate, lamivudine, and nevirapine

Regimen containing tenofovir disoproxil fumarate, lamivudine, and a boosted protease inhibitor

Regimen containing tenofovir disoproxil fumarate, lamivudine, and raltegravir

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and atazanavir/ritonavir

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and darunavir/ritonavir

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and dolutegravir

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and efavirenz

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and efavirenz (600 mg)

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and lopinavir/ritonavir

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and nevirapine

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and a boosted protease inhibitor

Regimen containing tenofovir disoproxil fumarate, emtricitabine, and raltegravir

Other regimen based upon WHO recommendations

Other regimen based upon WHO recommendations (specify)

Drug composition of clients current ART regimen

Treated with abacavir (ABC)

Treated with emtricitabine (FTC)

Treated with lamivudine (3TC)

Treated with zidovudine (AZT)

Treated with didanosine (DDI)

Treated with stavudine (D4T)

Treated with tenofovir (TDF)

Treated with efavirenz (EFV)

Treated with etravirine (ETV)

Treated with nevirapine (NVP)

Treated with rilpivirine (RIL)

Treated with atazanavir/ritonavir (ATV/r)

Treated with lopinavir/ritonavir (LPV/r)

Treated with darunavir/ritonavir (DRV/r)

Treated with ritonavir (RTV)

Treated with dolutegravir (DTG)

Treated with raltegravir (RAL)

Drug class of current ART regimen

Treated with nucleoside reverse transcriptase inhibitors (NRTIs)

Treated with nucleotide reverse-transcriptase inhibitors (NtRTIs)

Treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs)

Treated with protease inhibitors (PIs)

Treated with integrase strand transfer inhibitors (INSTIs)

Offer or refer for prevention services

Offer male and female condoms and condom-compatible lubricants

Offer or refer people who inject drugs to harm reduction services (needle and syringe programmes, opioid substitution therapy, other drug-dependence treatment and opioid overdose prevention and management)

Offer or refer to services for behavioural interventions to support risk reduction, particularly for people with HIV and members of key populations

Offer or refer to sexual and reproductive health services

Offer contraception and family planning services

Check womans pregnancy status

Offer prevention of mother-to-child transmission services (counselling)

Offer STI testing and treatment services

Date client was tested for hepatitis B virus (HBV)

Hepatitis B virus test result (HBsAg)

HBsAg test result was positive

HBsAg test result was negative

HBsAg test result was indeterminate

Date HBV test result (HBsAG) was returned to client

Date when client started treatment (TDF) for hepatitis B virus (HBV)

Hepatitis B virus treatment regimen prescribed

Date client was tested for hepatitis C virus (HCV antibody, HCV RNA or HCV core antigen)

Hepatitis C virus test result (HCV antibody, HCV RNA or HCV core antigen)

HCV test result was positive

HCV test result was negative

HCV test result was indeterminate

Date HCV test result was returned to client

Date when client started treatment for hepatitis C virus (HCV)

Date when client completed treatment for hepatitis C virus (HCV)

Hepatitis C virus treatment regimen prescribed

Hepatitis C viral load test date

Hepatitis C viral load test result (qualitative)

HCV was detected

HCV was not detected

Type of medicine client is prescribed

Client is prescribed interferon

Client is prescribed direct acting antivirals

Client is currently on TDF-based ART regimen

WHO clinical stage of client based on signs and symptoms. WHO clinical staging is a way to categorize HIV disease severity based on new or recurrent clinical events. There are 4 WHO clinical stages that range from mild symptoms (WHO clinical stage 1) to severe symptoms (WHO clinical stage 4).

Client is currently assessed to be at a clinical stage 1, based on clinical assessment and diagnostics

Client is currently assessed to be at a clinical stage 2, based on clinical assessment and diagnostics

Client is currently assessed to be at a clinical stage 3, based on clinical assessment and diagnostics

Client is currently assessed to be at a clinical stage 4, based on clinical assessment and diagnostics

Number of doses of antiretroviral therapy (ART) the client missed since the last visit, used for monitoring adherence

Client received results from viral load test

The date on which the client received results from viral load test

Date and time when the sample was collected to test the clients HIV viral load

Expected date when clients viral load test results will be returned and reviewed

Date of clients ART interruption (ART stop or missed drug pick-up)

Reason why client was not adherent

Client reported not being adherent because they forgot

Client reported not being adherent because of toxicity/side effects

Client reported not being adherent because they were busy

Client reported not being adherent because of a change of routine

Client reported not being adherent because of travel cost

Client reported not being adherent because of distance to clinic

Client reported not being adherent because client lost/ran out of pills

Client reported not being adherent because of a stock-out

Client reported not being adherent because of being too ill

Client reported not being adherent because of the pill burden

Client reported not being adherent because they felt well

Client reported not being adherent because of depression

Client reported not being adherent because of alcohol use

Client reported not being adherent because of substance use (i.e. drugs)

Client reported not being adherent because of stigma/disclosure concerns

Client reported not being adherent because of a lack of food

Client reported not being adherent because of poor palatability

Client reported not being adherent because of other reason for nonadherence

Client reported not being adherent because of other reason for nonadherence (specify)

Reason client intentionally stopped ART

Client stopped ART because of toxicity/side effects

Client stopped ART because of severe illness, hospitalization

Client stopped ART because drugs were out of stock

Client stopped ART because of lack of finances

Client stopped ART because HIV infection in infant was excluded

Client stopped ART because of other reason

Client stopped ART because of other reason (specify)

ART treatment failure

New or recurrent clinical event indicating severe immunodeficiency in adults or advanced or severe immunodeficiency in children

CD4 count at or below 250 cells/mm3 following clinical failure

The inability to achieve or maintain viral suppression below a certain threshold indicated by viral load above 1000 copies/mL based on two consecutive viral load measurements in 3 months, with adherence support following the first viral load test

General care activities to be performed during the care visit

Determine WHO clinical stage based on past and current HIV-related conditions

Determine if client is in an advanced stage of HIV, as a special package of services may be provided

Prepare client new to ART

Prepare, assess and support adherence

Manage current medications being taken by the client

Check womans pregnancy status

Provide family planning and contraception counselling

Support disclosure and partner notification

Counsel on risk reduction and combination HIV prevention approaches

Assess, prevent and manage noncommunicable diseases

Screen for and manage mental health problems

Screen for and manage and substance use issues

Provide psychosocial counselling and support

Manage pain and symptoms client is experiencing

Conduct a nutritional assessment and counsel on nutrition

Conduct a growth and development assessment

Provide support on infant and child feeding to mother or care giver

Coinfection prevention and treatment activities performed during the care visit